Posted on 05/04/2003 3:16:57 PM PDT by CathyRyan
What is SARS?
SARS stands for Severe Acute Respiratory Syndrome. The organism concerned primarily attacks the lungs. Victims develop a high fever, headache and dry cough followed by shortness of breath. Approximately 20-25 per cent of patients go on to develop pneumonia and some of those die. You are much more likely to die if you have another medical condition or are over the age of 40. Remarkable progress has being made in the last few weeks by research laboratories worldwide.
How can scientists have made so much progress so quickly?
Very recent advances in genetics have made it possible to compare suspect organisms with others. This is done by matching fragments of genetic material. Newly developed biological chips are now being used for diagnosis. They contain hundreds of fragments of known viruses. The chip is exposed to fluid containing the suspect organism and any match-ups of genetic material can be detected using laser-scanning technology. Initial work at the University of California at San Francisco, suggested that the culprit is a corona virus. Then a Vancouver research team mapped out the entire genetic sequence of the virus in just six days. Now many more research teams are completing the genetic map of their virus samples. The WHO – World Health Organisation – has designated a dozen or so labs around the world to work together on the problem. They have been co-operating in unprecedented fashion, rapidly exchanging information via the internet.
What has been achieved so far?
The WHO now has enough evidence to definitively state that a coronavirus is responsible. It is not a currently known variety. The coronavirus family can infect animals and people. They are responsible for possibly 30 per cent of colds and can also cause diarrhoea, particularly in children. No one is sure where this "new" virus came from. Many of the earliest victims in Southern China had links to animals and food. The best current guess is that the virus previously lived in an animal species and has somehow been able to jump the species barrier to be able to infect people. The candidate animals seem to be birds, pigs or cows. The WHO also believes that the virus can be held solely responsible for the disease. In other words they do not think it needs any help from other viruses or bacteria to cause the syndrome. Some scientists are not convinced. A few even doubt that the corona virus is the culprit. Some medical researchers think that other kinds of viruses (some have been found in samples from infected people) may be present in some of the more severe cases. Chinese scientists are claiming that a chlamydia bacterium is also involved.
How do you get SARS?
It was initially thought that close contact with a victim was necessary. Initially a few individuals infected a large number of medical personnel. It is believed that the virus is transmitted in droplets of fluid expelled by coughs and sneezes. It has also become clear that some victims are super infectious and can infect large numbers of people. No one knows why. When a Hong Kong high rise suffered an outbreak, it posed new questions about how the virus spreads Investigation of the outbreak revealed that one visitor to the building infected 321 residents. The Hong Kong health authorities have done an extensive investigation. Their published report concludes that the virus was spread primarily by a poorly designed and maintained plumbing system. It is known that corona viruses are excreted in urine and faeces. They are also present in other body fluids. Other modes of transmission may also have been involved.
Could someone get SARS from a blood transfusion?
Authorities are not completely sure. Genetic material from the virus has been found in the blood of sufferers. Many blood transfusion services are imposing restrictions on donors who have visited infected regions or who may have been quarantined because of contact with an infected person.
Can the virus be picked up by touching objects like door handles, lift buttons or eftpos key pads?
Until recently it was thought that the virus could only survive on a dry surface for a short time – possibly an hour or two. Now tests done by the CDC – the Center for Disease Control in the US have shown that the virus can live for at least 24 hours. Other labs familiar with animal corona viruses say that some can live for many days in such circumstances. They become reactivated when exposed to moisture.
Could I get the infection when flying in an airliner?
Yes that is possible. If you sit close to an infectious person you could easily catch it. There is some controversy about the ability of cabin air filtration systems to catch virus particles in the generally circulating air. Air from toilets is vented directly outside and is not re-circulated. The ideal situation would be for all cabin air to be expelled: thus avoiding re-circulation. Airlines say that would cost too much. The UK-based Aviation Research Institute claims that adopting the procedure would cost 20c per passenger per hour. Are you willing to pay the extra $2 for a trip to LA? It has to be said, however, that only a small number of air crew have come down with the infection, although it is likely that some travellers have contracted SARS that way. Some airlines have now implemented more stringent disinfecting procedures, even issuing masks on some routes. Perhaps you should ask your favourite airline just what they are doing to help keep you safe.
Should I wear a mask in public?
It is probably of very limited value unless you are the sufferer who is trying to avoid passing the virus to others. If masks fail to seal perfectly to the face, air is drawn in via the gaps instead of through the mask. Some authorities believe that moisture build up renders a mask useless in minutes rather than hours.
What is the incubation period?
It seems to average about 3-5 days. Although instances of a 10-day incubation period are known and slightly longer periods suspected to occasionally occur. It is not known with certainty when a sufferer becomes infectious; although it is assumed to be when they become unwell and develop a dry cough. The unpleasant possibility of the existence of apparently healthy carriers has not been ruled out.
Has a diagnostic test been developed?
Yes - a number of labs around the world have developed rapid tests which provide results in an hour or two. These tests are based on the ability to identify the genetic material specific to the virus. They are currently being refined and commercial versions for wide distribution will be available very soon. At present they appear to be too unreliable for widespread use. An accurate diagnostic test will be very valuable because at present SARS can only be excluded by finding out that a patient has another known condition. Another kind of test, one for the presence of antibodies, is also being developed. It identifies that the body has responded to the SARS infection. It will only be useful as a way of checking if a person has had previous exposure to the virus. It is believed that it should provide a valid reading about 21 days after the disease has begun.
How long will it take to develop a vaccine?
In theory a vaccine seems possible in a very short time. Health authorities are however very reluctant to release a vaccine to large numbers of people without thorough testing. Some say a vaccine could be available in a year, others are projecting a 3-5 year time frame. There is also the problem of producing millions of doses to inoculate very large numbers of people.
Is there a drug to cure SARS?
Sadly no. Some antiviral drugs plus steroids, have been tried with very limited success. A US lab is currently testing 2000 available drugs in the hope that one may be able to attack the virus. If this effort fails a new drug will probably be developed. But it is likely to take years to do so.
Will SARS eventually disappear or become harmless?
It may become much less dangerous, no one knows. The chances of it disappearing forever are remote. It may become like other respiratory viruses and pop up intermittently in the winter season just like flu. We have a new disease to contend with.
What happens if the virus changes just like the flu?
This is a major fear for doctors. There may already be some evidence that it is changing. The death rate is rising slightly and the residents of the Hong Kong high rise are much sicker than other victims. Autopsies on some of those victims have revealed damage to many organs outside the lungs. Doctors don’t know whether this represents a more severe infection. It could unfortunately also be the result of inappropriate medical treatment. Genetic sequencing of the virus is now being completed in many labs around the world using different virus samples. Initial comparison between Canadian and US virus samples gave an almost identical result. These new efforts around the world should provide a clearer picture about how variable the virus is and whether it is changing over time.
How can the spread of the virus be stopped?
The best approach appears to be rapid isolation of suspects and the quarantining of their close contacts. Unfortunately quarantine procedures in Hong Kong, Singapore and Toronto have been less than perfect. Some people do not obey instructions. Singapore now has an automatic heavy fine in place. Electronic tags and surveillance cameras are also being used. In Toronto legal action is being taken against a few people who have not complied with official directives. Some regions are having major successes. Vietnam may have completely arrested the spread of the disease and Singapore has had no healthcare workers infected for three weeks.
Is the virus more dangerous than other deadly diseases?
Some diseases are much more deadly. For example, AIDS in which the mortality rate is ultimately very high. Ebola fever has a death rate of over 50 per cent. On the other hand many diseases have a much lower mortality: Cholera 3-4 per cent, the 1918 Spanish Flu estimated at 1-3 per cent and malaria at 1-2 per cent.
If I get SARS what is the chance of dying?
The good news is that as many as 80 per cent of sufferers get better without developing pneumonia. If you are young and healthy your chances are very good. Unfortunately for reasons unknown, some people get pneumonia and need to be treated in intensive care. The WHO says that the death rate is now about 5 per cent. This sounds reassuring but Dr Henry Niman, a Harvard professor, thinks they are wrong. He says their statistics are unsound. They are comparing the number of people who die with the number of people who currently have the disease. They should he contends, be comparing the number who die with the number who get better. The official system is a bit like working out the match statistics before the game is over. Unfortunately the time between contracting the disease is from 13 days to four weeks. By Dr Niman’s reckoning the current death rate in Hong Kong is 18.25 per cent, in Singapore 13.8 per cent and Canada18.2 per cent. Sobering news indeed.
Mortality is very closely linked to age. Below the age of 30 it is virtually zero. From 40 to the age of 55 the death rate is about 8 per cent. After that it climbs steeply.
Whichever figures you choose, they only apply to the current situation. Future trends are pure speculation. If however the current rate of spread continues, we are faced with some sobering possibilities. Currently the number of cases is doubling every 22 days. The number of deaths is doubling over a 12-day period. If such trends continue unchanged, year’s end would see ten million cases worldwide.
What is the best way to stay healthy?
Ultimately our immune systems are the best defence. All the usual advice applies. Eat a healthy diet, get enough sleep and try to avoid stress. A good multi vitamin pill might help. There are many herbs and potions that many swear by. It might also be useful to suck zinc lozenges at the first signs of feeling unwell. Zinc is know to be helpful in minimising the effects of cold viruses.
Personal hygiene is very important. All authorities recommend regular thorough hand washing. If you are out and about the best plan is to carry an antibacterial hand gel. These alcohol-based rubs are carried by most chemists. You don’t need water, so there is no necessity to dry your hands. Tests have shown they work much faster and better than anti-bacterial soaps. Hong Kong authorities have advised pressing elevator buttons with your car keys. (Our eftpos machine could require a little practice.) They advise closing the toilet lid prior to flushing and also recommend daily cleaning with a dilute bleach solution applied to toilets and all surfaces possible, particularly items like telephones. It may be necessary to wrap the computer keyboard in cling wrap.
If I have just returned from overseas, get sick and think that I might have SARS what should I do?
Contact your doctor or hospital by telephone and ask for advice. Do not use public transport or a taxi to seek help.
Will SARS reach New Zealand?
It seems highly likely that it will – if it is not already here. Hopefully the individuals involved, and their contacts, can be quickly isolated. Recent events suggest that procedures at our airports are not good enough. Perhaps we should purchase camera- type body temperature measuring machines now being used in Singapore and some other airports. They could be set up in such a way that arriving travellers could be checked at the same times as their luggage is being scanned for illicit fruit and other foods.
Dr Maurice McKeown is a Tauranga orthodontist and former academic medical researcher
Yes. And this is the really troubling issue. Considering most of those 10M cases will be in the PRC, consider the political implications. Plus, if the doubling rate continues after the end of the year...20M, 40M, etc. I can see all kinds of interesting scenarios...including the use of nuclear weapons in the PRC at some point.
I saw in heaven another great and marvelous sign: seven angels with the seven last plagues--last, because with them God's wrath is completed...After this I looked and in heaven the temple, that is, the tabernacle of the Testimony, was opened. Out of the temple came the seven angels with the seven plagues. They were dressed in clean, shining linen and wore golden sashes around their chests. Then one of the four living creatures gave to the seven angels seven golden bowls filled with the wrath of God, who lives for ever and ever. And the temple was filled with smoke from the glory of God and from his power, and no one could enter the temple until the seven plagues of the seven angels were completed.
Uh, yeah. 100% of people with AIDS will die. Pretty high.
These look like FL_engineer's numbers
He seems to think LSU and Tulane plagarized his work with their announcement re: SARS last week.
What the heck have you been smoking?
Ho hum.
SARS: More questions than answers
Ho hum.
It sounds like people who engage in anal sex with multiple partners will be at increased risk. Given also that people with AIDS are less likely to exhibit symptoms (since the pneumonia comes from the immune symptoms efforts to fight off the virus), they may become super-spreaders throughout the gay community
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.